Patel Shamil, Reiss George
Banner-University Medical Center Phoenix, Phoenix, USA.
J Ophthalmol. 2023 May 10;2023:5625990. doi: 10.1155/2023/5625990. eCollection 2023.
To investigate the clinical effectiveness of canaloplasty performed with an ab interno technique using the iTrack microcatheter (Nova Eye Medical) in patients with mild-moderate glaucoma as compared to severe glaucoma.
This is a retrospective single-center case series. Patients were preoperatively categorized as mild/moderate vs. severe glaucoma assessed using the mean deviation (MD) score and controlled group (baseline intraocular pressure (IOP) ≤18 mmHg) vs. uncontrolled group (>18 mmHg). All patients with glaucoma were eligible for recruitment except those who had undergone previous glaucoma surgery (with the exception of selective laser trabeculoplasty or SLT). Patients underwent canaloplasty via an ab interno surgical technique with or without phacoemulsification and were monitored for IOP, glaucoma medication usage, and surgical complications.
In total, 72 eyes were followed for 3.4 ± 0.5 years. Mean pre-op IOP (mmHg) was 19.3 ± 7.7 in the standalone group ( = 9) and 18.5 ± 5.6 in the combined group ( = 63) (=0.38). At the last follow-up, mean IOP reduced by 36% to 12.4 ± 4.4 (=0.02) in the standalone group and by 26% to 13.7 ± 4.8 in the combined group ( < 0.001). Mean pre-op IOP (mmHg) was 18.6 ± 5.2 in the severe group ( = 24) and 18.6 ± 6.2 in the mild-moderate group ( = 48) (=0.48). Mean IOP was 14.1 ± 6.3 (-24%; < 0.001) and 13.3 ± 3.7 (-29%; < 0.001), respectively, at the last follow-up. Mean glaucoma medication usage decreased from 2.5 ± 0.9 to 2.1 ± 0.9 (-15%; =0.083) in the severe group and 2.3 ± 1.0 to 1.4 ± 1.3 (-40%; < 0.001) in the mild/moderate group. There was one localized Descemet's membrane detachment in the moderate group.
iTrack canaloplasty achieved a statistically significant IOP reduction in mild-moderate and severe eyes and was found to be an effective option for reducing IOP and medications in patients with mild-moderate primary open-angle glaucoma (POAG). In severe eyes, it has reduced IOP while the medications remained stable.
研究使用iTrack微导管（Nova Eye Medical）经内路技术进行的房角成形术在轻中度青光眼患者与重度青光眼患者中的临床疗效。
这是一项回顾性单中心病例系列研究。术前根据使用平均偏差（MD）评分将患者分为轻/中度与重度青光眼，以及根据基线眼压（IOP）≤18 mmHg分为对照组与眼压>18 mmHg的未控制组。除曾接受过青光眼手术（选择性激光小梁成形术或SLT除外）的患者外，所有青光眼患者均符合纳入标准。患者通过经内路手术技术接受房角成形术，可联合或不联合超声乳化白内障吸除术，并对眼压、青光眼药物使用情况及手术并发症进行监测。
总共72只眼随访了3.4±0.5年。单纯组（n = 9）术前平均眼压（mmHg）为19.3±7.7，联合组（n = 63）为18.5±5.6（P = 0.38）。在最后一次随访时，单纯组眼压平均降低36%至12.4±4.4（P = 0.02），联合组降低26%至13.7±4.8（P < 0.001）。重度组（n = 24）术前平均眼压（mmHg）为18.6±5.2，轻中度组（n = 48）为18.6±6.2（P = 0.48）。在最后一次随访时，平均眼压分别为14.1±6.3（降低24%；P < 0.001）和13.3±3.7（降低29%；P < 0.001）。重度组青光眼药物平均使用量从2.5±0.9降至2.1±0.9（降低15%；P = 0.083），轻/中度组从2.3±1.0降至1.4±1.3（降低40%；P < 0.001）。中度组有1例局限性Descemet膜脱离。
iTrack房角成形术在轻中度和重度眼中均使眼压有统计学意义的降低，并且被发现是降低轻中度原发性开角型青光眼（POAG）患者眼压和减少药物使用的有效选择。在重度眼中，它降低了眼压，同时药物使用情况保持稳定。
